Until relatively recently the concept of agoraphobia was centered almost exclusively on fear and avoidance of public places and panic was viewed as incidental to this. Today, the theory of panic disorder takes greater prominence and provides some insight into agoraphobia symptoms.
Agoraphobia may be associated with panic but it can also develop in the absence of a history of panic. When related to panic agoraphobia mostly tends to develop as a consequence of repeated panics and the avoidance of places and situations that become associated with panic. In situations where agoraphobia is not preceded by panic it is very often the case that some other phobia (illness, crime, etc) is present.
There is no particular pattern to the onset of agoraphobia. It may be sudden, or may gradually develop over weeks or even years. Symptoms may come and go and the severity of symptoms may also vary. In some people symptoms may completely disappear only to reappear months or even years later. There is some evidence to suggest that stressful life events may culminate to a point that results in triggering the onset of symptoms.
The idea that agoraphobia revolves around a fear of open spaces is now regarded as too narrow a concept. The reality is that both fear and avoidance are far more extensive. People with agoraphobia tend to have high levels of general anxiety. These can fluctuate somewhat and bad days can be followed by good. In general however levels of anxiety are relatively persistent and may last for several years.
Agoraphobia typically affects roughly twice as many women as men and tends to reveal itself in early adulthood. It is quite common to find the person suffers with additional psychological problems. Depression, obsessive-compulsive symptoms, social phobia and generalized anxiety are typical examples.
In situations where escape is difficult the person with agoraphobia feels symptoms of intense distress. The body gears itself to respond in a manner that would normally suggest flight from the situation. The heart rate increases, blood pressure goes up, and the blood stream floods with sugars and hormones in preparation. However, where flight is restricted additional symptoms of intense anxiety also appear. The person may feel sick, may shake, hyperventilate and feel chest pains. In the midst of this the person also wants to avoid humiliation and so tries to exert additional control over their situation. This often compounds the situation and the person may experience a panic episode. Not surprisingly, many people with agoraphobia go to some length to avoid places that trigger such symptoms.
People with agoraphobia typically avoid situations such as public transport or enclosed places such as tunnels, crowded cinemas, supermarkets and queues. Agoraphobics dislike traveling long distances from home and tend to avoid physical activity or other stimulants (e.g. coffee) that might trigger anxiety. In situations where the person becomes confined they feel a tremendous need to get away.
One of the notable issues about agoraphobia is the ability of the individual to overcome or at least cope with their symptoms at times of greatest need. An example might be having a picnic with friends. For the agoraphobic this involves digging deep into their limited resources in order to cope with a situation they would normally avoid. The fact that some people are able to do this often confuses onlookers who begin to wonder whether the symptoms are little more than attention seeking. In fact the consequences of such actions are often completely exhausting for the person concerned who may then lack sufficient resources to complete other tasks.
Published On: June 01, 2011